Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 40QA01263300 | NJ |
NPI | 1265618847 |
---|---|
Provider Name | Mr. William Joseph Neenan |
First Address | Basking Ridge, NJ 07920-2926 |
Second Address | Basking Ridge, NJ 07920-2926 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2008 |
Last Update Date | 14/01/2008 |